Academic Ophthalmology, University of Nottingham, Nottingham, UK.
School of Medicine, University of Nottingham, Nottingham, UK.
Br J Ophthalmol. 2021 Mar;105(3):328-333. doi: 10.1136/bjophthalmol-2020-316128. Epub 2020 Jun 24.
BACKGROUND/AIMS: To examine the incidence, causative microorganisms and in vitro antimicrobial susceptibility and resistance profiles of infectious keratitis (IK) in Nottingham, UK.
A retrospective study of all patients who were diagnosed with IK and underwent corneal scraping between July 2007 and October 2019 (a 12-year period) at a UK tertiary referral centre. Relevant data, including demographic factors, microbiological profiles and in vitro antibiotic susceptibility of IK, were analysed.
The estimated incidence of IK was 34.7 per 100 000 people/year. Of the 1333 corneal scrapes, 502 (37.7%) were culture-positive and 572 causative microorganisms were identified. Sixty (4.5%) cases were of polymicrobial origin (caused by ≥2 different microorganisms). Gram-positive bacteria (308, 53.8%) were most commonly isolated, followed by Gram-negative bacteria (223, 39.0%), acanthamoeba (24, 4.2%) and fungi (17, 3.0%). (135, 23.6%) was the single most common organism isolated. There was a significant increase in spp (p<0.001) and significant decrease in spp (p=0.004) over time. The in vitro susceptibilities of Gram-positive and Gram-negative bacteria to cephalosporin, fluoroquinolone and aminoglycoside were 100.0% and 81.3%, 91.9% and 98.1%, and 95.2% and 98.3%, respectively. An increase in resistance against penicillin was observed in Gram-positive (from 3.5% to 12.7%; p=0.005) and Gram-negative bacteria (from 52.6% to 65.4%; p=0.22).
IK represents a relatively common and persistent burden in the UK and the reported incidence is likely underestimated. Current broad-spectrum antimicrobial treatment provides a good coverage for IK, although challenged by some level of antimicrobial resistance and polymicrobial infection.
背景/目的：在英国诺丁汉，检查传染性角膜炎（IK）的发病率、病原体微生物以及体外抗菌药物敏感性和耐药性情况。
对 2007 年 7 月至 2019 年 10 月（12 年期间）在英国三级转诊中心诊断为 IK 并接受角膜刮片的所有患者进行回顾性研究。分析了相关数据，包括人口统计学因素、IK 的微生物谱和体外抗生素敏感性。
IK 的估计发病率为每 10 万人/年 34.7 例。在 1333 例角膜刮片中，502 例（37.7%）为培养阳性，鉴定出 572 种病原体微生物。60 例（4.5%）为混合感染（由≥2 种不同微生物引起）。革兰氏阳性菌（308 株，53.8%）最常被分离，其次是革兰氏阴性菌（223 株，39.0%）、棘阿米巴（24 株，4.2%）和真菌（17 株，3.0%）。最常见的单一病原体是 （135 株，23.6%）。随着时间的推移， 属（p<0.001）显著增加， 属（p=0.004）显著减少。革兰氏阳性菌和革兰氏阴性菌对头孢菌素、氟喹诺酮类和氨基糖苷类药物的体外敏感性分别为 100.0%和 81.3%、91.9%和 98.1%、95.2%和 98.3%。革兰氏阳性菌（从 3.5%增加到 12.7%；p=0.005）和革兰氏阴性菌（从 52.6%增加到 65.4%；p=0.22）对青霉素的耐药性增加。
IK 在英国是一种相对常见且持续存在的疾病负担，报告的发病率可能被低估。目前广泛使用的抗菌药物治疗方案对 IK 有较好的覆盖，但受到一定程度的抗菌药物耐药性和混合感染的挑战。
